'Go home...no pity here;' When hospital halls become hub for violence against women

“Go home, they will disappear.”

That, she says, is what a health worker told her when she sought medical attention for fibroids that were causing her pain.

“He told me, these things are small, they will go away. Go home. Even if you feel pain, just manage the pain,” Sunday recalls.

She had walked into a health facility expecting answers. Instead, she says, she left feeling dismissed and unheard.

Her experience raises a difficult question: what happens when a woman seeks help for a reproductive-health problem but is made to feel that her pain does not matter?

According to Melinda Mugambi of the Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN), Sunday's experience may raise questions of negligence, poor-quality care and violations of her rights, but does not necessarily constitute obstetric violence under the narrower understanding of the term.

“It definitely is a form of negligence or a form of violation of rights, such as human dignity, and also a violation of the rights to the highest attainable standard of health care,” Mugambi says. “But it doesn't necessarily fall within obstetric violence.”

Obstetric violence is generally discussed in relation to pregnancy, childbirth, and the postpartum period. But women's experiences of reproductive healthcare extend far beyond motherhood.

They seek treatment for fibroids, undergo gynaecological examinations, seek contraception and fertility care, and receive treatment for pregnancy complications.

Human Rights Watch has argued that abusive treatment in reproductive healthcare can amount to a human-rights violation and a form of gender-based violence.

Its 2024 analysis of obstetric violence in Africa documents experiences including physical and verbal abuse, humiliation, neglect, abandonment, denial of pain relief, painful examinations, lack of informed consent, breaches of privacy and prolonged delays in care.

For Roza, the mistreatment she recalls happened during a medical emergency.

About 15 years ago, she developed a hydatidiform mole, a pregnancy-related condition in which abnormal tissue develops inside the uterus.

Her condition deteriorated until she fainted. She says she was eventually transferred from Vihiga to Kisumu, where she required a blood transfusion. In the process, she lost her belongings, including her phone.

She remembers the maternity ward and other women undergoing treatment around her.

“We were injected with a drug they called dawa ya uchungu. I later learnt that it was called oxytocin. Others were given misoprostol, which they had to swallow. After a few minutes, all hell broke loose,” she recalls.

“There were labour cries, pain cries, humiliation cries, fear cries, exhaustion cries, and cries of helplessness all in one room that night.”

“There was no privacy. All the women could see each other, in pain, undressed and uncovered,” Roza says.

She also alleges that the nurse in charge that night was intoxicated and that there was a delay before she was transferred to Kisumu.

About a month later, she began bleeding again. She fainted and sought treatment elsewhere, where she underwent an evacuation.

“I encountered it a long time ago, about 15 years ago, but I remember.”

Roza's account highlights the importance of timely referral, privacy, and communication during reproductive-health emergencies.

Human Rights Watch similarly identifies neglect, prolonged delays, lack of privacy, and failures around informed consent as forms of mistreatment that can undermine women's rights in reproductive healthcare.

When poverty enters the maternity ward

Another woman, whose identity is withheld at her request, says her experience began during pregnancy.

She regularly attended prenatal clinics. When the time came to deliver, she was referred to another hospital.

Then she discovered she was carrying twins.

The news brought another layer of anxiety. She says nurses were harsh towards her because she did not have some of the items expected at the maternity ward, including napkins and shawls.

She had arrived to give birth. Instead, she says, she felt judged for what she could not afford.

Her experience raises another question: does poverty influence how women are treated when they seek maternity care?

Human Rights Watch has documented inequalities in access to maternal healthcare, including socioeconomic disparities in access to skilled birth attendants.

Its broader analysis also identifies socioeconomic status as a factor that can expose women and girls to discriminatory or abusive treatment in reproductive healthcare.

For this woman, poverty did not stop at the hospital entrance. She says it followed her into the maternity ward.

“The pain is still in my memory”

For Silvia, whose name has been changed to protect her privacy, the memory is physical.

She remembers fingers being inserted painfully into her cervix. She says she began bleeding heavily and was subsequently given injections whose purpose she did not understand.

When she sustained a tear, she required suturing of the tear.

But what remains most strongly with her is how she says she was treated during the procedure.

Her account raises questions about informed consent and communication. A medically necessary procedure does not remove a patient's right to understand what is being done to her or to be treated respectfully.

Human Rights Watch has identified painful examinations, lack of informed consent and failure to provide adequate pain management among concerns in abusive reproductive healthcare.

Mugambi says women have a right to information that enables them to participate in decisions concerning their healthcare.

The issue, therefore, is not simply whether an examination, injection, or suturing was medically necessary. It is also whether the woman understood what was happening, whether appropriate consent was obtained, and whether her pain was adequately addressed.

“The hospital is not a place of pity”

In Kakamega, Drucella, not her real name, says her experience began with a long wait.

She had gone to the hospital to give birth, but says she waited for hours before she was attended to.

One nurse, she says, told her:

“The hospital is not a place of pity because, as you were looking for pregnancy, you were enjoying.”

Another nurse who was supposed to attend to her, she says, told her she was busy.

Later, when she was due to receive an injection intended to assist cervical dilation, she says the procedure went wrong. Drucella recalls that the syringe bent or folded while it was inside her vein.

For her, the experience was not only about what happened during the procedure. It was also about waiting for care and feeling that her concerns were not being taken seriously.

Her account points to the role of staffing, workload and communication in determining the quality-of-care women receive.

The experiences of these women are different.

Sunday sought treatment for fibroids and says she was dismissed.

Roza experienced a pregnancy-related emergency involving severe bleeding and delayed referral.

The mother of twins says she was judged because she could not afford basic maternity supplies.

Drucella remembers prolonged waiting, hurtful words and a frightening injection.

“Currently, there's no legislation around obstetric violence in Kenya,” she says.

But the absence of a specific offence does not mean women have no legal protections.

Depending on the circumstances, women may rely on broader constitutional, health, professional and human-rights frameworks when seeking redress.

Mugambi also says the discussion must examine the conditions in which healthcare workers operate.

“Was the hospital adequately staffed to handle the many cases of birth that they handled that led to the violation?” she asks.

Staff shortages, inadequate supplies, weak referral systems and pressure on health workers can affect the care patients receive. Human Rights Watch similarly identifies under-resourced health systems, inadequate staffing and limited access to medicines, including pain-management medicines, as factors that can contribute to abusive maternity care.

But systemic pressure cannot by itself explain away a patient's experience.

A woman undergoing a procedure needs to understand what is happening.

A woman in labour should not be humiliated because she lacks money or maternity supplies.

And a patient should be able to seek care without fear that her dignity will be disregarded.

For women who experience mistreatment, the question then becomes what happens after they leave the hospital.

Mugambi says available remedies depend on the circumstances and may include professional complaints, medical-negligence claims or other legal mechanisms.

For some women, it may mean an apology. For others, accountability, disciplinary action or changes that prevent another patient from experiencing similar treatment.

“Normally when we get cases, we even ask our clients, what does justice look like for you?” Mugambi says.

That question captures the heart of the issue. Because women are more than mothers.

They are more than pregnancies, wombs, cervixes, fibroids, miscarriages or delivery statistics.

Human Rights Watch argues that addressing abusive reproductive healthcare requires more than changing individual behaviour. It points to the need for stronger accountability, adequate staffing and training, privacy, informed consent, better data and properly resourced reproductive-health services.

For Roza, it has lasted about 15. For Silvia, the pain remains vivid.

For Drucella, the words spoken while she waited for care remain part of her memory.

Their stories do not suggest that every healthcare worker is abusive. Thousands provide compassionate care, often under difficult conditions.

But their experiences raise a question Kenya's health system cannot answer with statistics alone:

When a woman walks into a health facility, does she enter simply as a patient or as a person whose dignity, voice, choices and pain must also be protected?

That is where reproductive healthcare becomes about more than motherhood.

It becomes about her right to be heard, her right to understand what is happening to her body, and her right to receive care without surrendering her dignity.